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P Landrigan

Publications and source records attributed to P Landrigan.

At least 19 recordsLinked to original sources
PubMed2004

Estimating the global burden of disease of mild mental retardation and cardiovascular diseases from environmental lead exposure.

The disease burden from exposure to lead resulting in mild mental retardation (due to IQ point decreases) and cardiovascular outcomes (due to increases in blood pressure) was estimated at a global level. Blood lead levels were compiled from the literature for 14 geographical regions defined by the World Health Organization according to location and adult and child mortality rates. Adjustments were applied to these levels, where appropriate, to account for recent changes relating to the implementation of lead-reduction programs and the lower levels seen in rural populations. It is estimated that mild mental retardation and cardiovascular outcomes resulting from exposure to lead amount to almost 1% of the global burden of disease, with the highest burden in developing regions. This estimate can be used to assess the magnitude of the benefits that could be accrued by increasing the global coverage of lead-reduction programs.

Adult↗
PubMed2000

Video display terminals and miscarriage.

Concern about possible reproductive effects of using video display terminals (VDTs) was stimulated by reports of clusters of adverse pregnancy outcomes among groups of women who used VDTs. Exposure to electromagnetic fields emitted from VDTs was suspected of increasing the risk of miscarriage. Ten epidemiological studies have examined associations between VDT use and miscarriage, most of which were not originally designed to examine this hypothesis and suffer from methodological limitations. We review these studies and present previously unpublished data in support of our conclusion that for most women in modern offices, work with VDTs does not increase their exposure to electromagnetic fields or increase their risk of miscarriage. The miscarriage risk for women who work at high-stress jobs or with older, high-emission VDTs (ELF > 3 mG), however, is still uncertain.

Abortion, Spontaneous↗
PubMed1998

Lead absorption and renal dysfunction in a South African battery factory.

OBJECTIVES: To test the association between inorganic lead (Pb) exposure, blood pressure, and renal function in South African battery factory workers, with both conventional and newer measures of renal function and integrity. METHODS: Renal function measures included serum creatinine, urea, and urate (n = 382). Urinary markers (n = 199) included urinary N-acetyl-beta-D-glucosaminidase (NAG), retinol binding protein, intestinal alkaline phosphatase, tissue non-specific alkaline phosphatase, Tamm-Horsfall glycoprotein, epidermal growth factor, and microalbuminuria. RESULTS: Mean current blood Pb was 53.5 micrograms/dl (range 23 to 110), median zinc protoporphyrin 10.9 micrograms/g haemoglobin (range 1.9 to 104), and mean exposure duration 11.6 years (range 0.5 to 44.5). Mean historical blood Pb, available on 246 workers, was 57.3 micrograms/dl (range 14 to 96.3). After adjustment for age, weight and height, positive exposure response relations were found between current blood Pb, historical blood Pb, zinc protoporphyrin (ZPP), and serum creatinine and urate. Blood pressure was not associated with Pb exposure. Among the urinary markers, only NAG showed a positive association with current and historical blood Pb. CONCLUSION: An exposure-response relation between Pb and renal dysfunction across the range from < 40 to > 70 micrograms/dl blood Pb was found in this workforce, with conventional measures of short and long term Pb exposure and of renal function. This could not be explained by an effect on blood pressure, which was not associated with Pb exposure. The findings probably reflect a higher cumulative renal burden of Pb absorption in this workforce in comparison with those in recent negative studies. The results also confirm the need for strategies to reduce Pb exposure among industrial workers in South Africa.

Acetylglucosaminidase↗
PubMed1995

Occupational Injuries: Epidemiology, Prevention, and Treatment.

The authors review the current data on patterns of adolescent employment and examine the epidemiology of work-related injuries among adolescents in the U.S. They summarize the laws that have been created to protect adolescents against exploitation and injury in the workplace and the erosion of those measures that has occurred since 1980. Finally, the authors offer recommendations for the diagnosis and prevention of occupational injury among adolescents.

Journal Article↗
PubMed1992

The mortality of lead smelter workers: an update.

OBJECTIVES: Mortality studies of lead workers have shown excesses of nonmalignant renal disease and cerebrovascular disease. Animal studies and one human study have shown excess kidney cancer. We have updated a mortality study of male lead smelter workers (n = 1990). METHODS: An analysis was conducted using standard life table techniques. The updated analysis added 11 years of follow-up and 363 new deaths. RESULTS: The original study had found elevated but nonsignificant risks for kidney cancer, stroke, and nonmalignant renal disease, probably attributable to lead exposure. Deaths from accidents and nonmalignant respiratory disease were significantly elevated, but probably not as a result of lead exposure. In the updated study, no new deaths from nonmalignant renal disease occurred (9 observed, standardized mortality ratio = 1.21). Three more deaths from kidney cancer were observed, yielding a standardized mortality ratio of 1.93 (9 observed, 95% CI = 0.88, 3.67), which increased for those who had worked in areas with the highest lead exposure (8 observed, standardized mortality ratio = 2.39, 95% CI = 1.03, 4.71). Cerebrovascular disease remained elevated for those with more than 20 years of exposure (26 observed, standardized mortality ratio = 1.41, 95% CI = 0.92, 2.07). CONCLUSIONS: This cohort with high lead exposure showed a diminishing excess of death from nonmalignant renal disease, a continued excess from kidney cancer, and an excess of cerebrovascular disease only in those with longest exposure to lead.

Accidents, Occupational↗
PubMed1991

[Current problems of epidemiology and toxicology of the occupational action of lead (review of the literature)].

The focus of current research on industrial lead toxicity is on the definition of dose-response relationships, particularly++ at low levels of exposure. Major interest surrounds the development of biochemical and physiologic markers of subclinical toxicity. Need exists to better delineate the toxicity of lead on the peripheral and central nervous system the kidneys, the cardiovascular system and the reproductive organs. To obtain more accurate information on cumulative individual exposure to lead, future research on lead toxicity will increasingly utilize X-ray fluorescence (XRF) analysis for determination of the lead content in bone.

Anemia↗
PubMed1987

Anaesthetic management for oophorectomy in pulmonary lymphangiomyomatosis.

Pulmonary lymphangiomyomatosis is an idiopathic disease, resulting in severe respiratory impairment. Bilateral oophorectomy has led to objective and subjective amelioration of the pulmonary pathology. In the anaesthetic management of such a patient, careful attention must be paid to pulmonary and systemic haemodynamics, and gas exchange. We describe the successful anaesthetic management of a 34-year-old female, using epidural anaesthesia, and pulmonary artery catheterization. Although the intraoperative and immediate postoperative courses were heralded by marked cardiorespiratory stability, refractory respiratory failure developed, and she died five months after surgery.

Adult↗
PubMed1987

Use of court records for supplementing occupational disease surveillance.

To conduct surveillance of occupationally related health events, the New Hampshire Division of Public Health Services analyzes death certificates and workers' compensation claims. In an effort to bolster these limited data sources, a previously unrecognized data-set comprised of court records was explored. Court records obtained from the Federal District Court proved to be a readily accessible and detailed source of information for identifying suspected cases of asbestos-related disease and potential sources of asbestos exposure.

Asbestosis↗
PubMed1977

A study of the effects of systemic administration of adrenal glucocorticoids in an experimental model of hypersensitivity pneumonitis.

To study the effects of steroids on the pulmonary lesions in experimental hypersensitivity pneumonitis, rabbits were sensitized to ovalbumin (OA) by injections of OA into footpads and 3 weeks later they were subjected to two successive aerosol challenges with OA at an interval of 48 hr. Injections of hydrocortisone sodium succinate 10 mg twice daily (but not at the reduced dosage of 5 mg twice daily) or methyprenisolone acetate 5 mg twice daily beginning 30 min before the first challenge and continued to the time of killing reduced the extent and intensity of vasculitis in both the treated groups and showed less alveolar septal thickening in the hydrocortisone treated group and less alveolar consolidation in the methylprednisolone treated group compared to the pulmonary lesions in the rabbits which were sensitized and then subjected to OA aerosol challenges, but received no treatment. In view of the observation that even in a steroid sensitive species like the rabbit, extensive pulmonary changes like alveolar consolidation, septal thickening and vasculitis persisted in spite of treatment with relatively large doses of these steroids, it was felt that in human hypersensitivity pneumonitis steroids might only suppress the warning symptoms without substantially affecting the progress of the pulmonary lesions.

Alveolitis, Extrinsic Allergic↗
PubMed1975

Cryptogenic fibrosing alveolitis.

Clinical, radiographic, and histologic data, together with pulmonary function features, in eleven patients with cryptogenic fibrosing alveolitis, are described in the following study. All these patients presented with a history of exertional dyspnea. Eight of the eleven had radiographic evidence of pleural involvement as manifested by blunting of one or both costophrenic angles. A restrictive defect was present in eight patients, all of whom had x-ray changes showing diffuse involvement. One of the patients presented showed marked improvement in all parameters including a repeat lung biopsy. Immunofluorescent studies of the lung biopsies from six patients revealed no evidence of immunologic damage. Based upon the histologic pattern of pulmonary reaction in the biopsies and the intervals between the onset of symptoms and the time of biopsy, a tenative scheme of temporal evolution of this disease is presented. Lung injury may lead either directly to diffuse interstitial pulmonary fibrosis (DIPF) or lungs may react to injury by an initial alveolar, mural or mixed pattern, all of which might ultimately progress to DIPF. An initial alveolar or mural pattern might change to a mixed pattern.

Adult↗